'Dr. Ken Cheung struggles for a few seconds to describe how he views himself within Alberta’s rapidly privatizing health-care system.
“I feel like I’m a conscientious objector,” said Cheung, an anesthesiologist for 25 years at Calgary’s Foothills Medical Centre.
As a supporter of public health care, Cheung said he objects to a policy that requires him to work in one of Alberta’s private, for-profit chartered surgical facilities, or CSFs.
Those CSFs are now churning out tens of thousands of surgeries, mostly in Calgary and Edmonton, every year under a United Conservative Party government.
Cheung, who is nearing full retirement, and another Calgary anesthesiologist, with decades of work ahead of her, have so far avoided being forced to work in CSFs by trading shifts with colleagues.
Both said they resent being directed to help establish the for-profit surgery industry in Alberta when there are clear signs it is undermining the timely care of patients in the public system.
“I am not working in those facilities because I find it morally inappropriate to do so, and I don’t want to be part of that,” the second anesthesiologist said.
On Friday, the UCP government doubled down on its CSF strategy, announcing it would be funding an additional 50,000 procedures over the next three years in chartered surgical facilities “to reduce surgical wait times.”
But a Tyee investigation found:
Anesthesiologists in Calgary are being scheduled by senior Alberta health managers, in response to government directives, to work in CSFs, sometimes against their will.
Anesthesiologists, and in some cases surgeons, have been preferentially assigned to work in chartered surgical facilities over public hospitals, including in response to political influence exerted by CSF owners.
The government has ignored repeated warnings, based on data, that the rapid expansion of surgeries in CSFs has been increasing wait times in public hospitals for critical surgeries including lung, prostate and colorectal cancer, and children’s organ transplants.
The government refused to pause the expansion of private surgeries despite being shown evidence they were neither saving money nor significantly reducing wait times. Instead, the government continues to take money out of the public system to fund the expansion of private surgeries.
“There is an anesthesiology shortage,” said one former senior health executive who had urged the prioritization of critical surgeries.
“But they [the UCP government] did not want to slow down the volume of surgeries in CSFs, and the problem just got worse.”
“Alberta Health didn’t seem to care who gets surgery,” said Dr. Braden Manns, a former vice-president of Alberta Health Services, or AHS. “They care about how many surgeries get done in a year.”'
The surgical initiative is a policy to expand the use of private surgical facilities for cataract, podiatry and particularly orthopedic surgeries such as knee and hip replacements in an attempt to reduce chronically long wait times.
Most spoke on condition of anonymity because they variously said they were bound by non-disclosure agreements or feared it would affect their current or future employment.
All referenced a climate of fear within the health-care system, engendered by a string of high-profile dismissals, including the entire AHS board of governors — twice — and former CEO Athana Mentzelopoulos, whose wrongful-dismissal lawsuit has spurred a criminal and several other investigations.
Three former executives independently described a culture in which some senior government politicians and their staff displayed open mistrust of data and advice. They also describe an ideologically based “hatred” for AHS, the giant organization that for more than a decade managed the province’s public health-care system.
The government is in the process of dismantling AHS and replacing it with multiple agencies, which health policy experts and staff have said is unnecessary and is causing chaos.
“We would bring the data to the ministers and deputy ministers and senior staff but they didn’t trust AHS, they didn’t trust us, and they didn’t want to listen,” said one former senior AHS executive.
“So part of it is ideology, part of it is that no matter what you said to them, they didn’t believe it. They didn’t care.”'
Meanwhile, wait times for nearly all critical cancer and other surgeries are far outside acceptable wait-time standards.
Legislative changes have enabled aggressive expansion of contracting and volumes, but the review said “questions remain about the ability of such an approach to maintain quality, sustainability, and equitable access, especially in areas requiring complex care co-ordination.”
The initial plan for rolling out the Alberta Surgical Initiative was multi-pronged but largely focused on an expansion of both public system capacity through infrastructure investments and the contracting out of surgeries to private, for-profit providers, some with their own purpose-built facilities.
But the expansion of the public system was quickly abandoned and the government set a volume target of 30 per cent of all surgeries within private facilities.
“There was no evidence to support that,” one former executive said, adding that there was no planning for whether the private system could accommodate that volume or what the domino effect might be on the public system in terms of staffing and other resources.
“They just said they want to have a third of the volume being done in private facilities.”
https://thetyee.ca/News/2025/11/17/Alberta-For-Profit-Surgery-Push-Failing/
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